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URETHRAL STRICTURE

Urethral stricture refers to the abnormal narrowing of the urethra, the tube that releases urine from the body.

Urethral Stricture

Causes

Inflammation or scar tissue from surgery, disease, or injury may be the reasons causing Urethral stricture Men who have a history of sexually transmitted disease (STD), repeated episodes of urethritis or benign prostatic hyperplasia (BPH) are at an increased risk of facing urethral stricture. A higher risk of urethral stricture is also associated with an injury or trauma to the pelvic region. Insertion of any instrument into the urethra (catheter or cystoscope) can also lead to the development of urethral strictures.

Symptoms

  • Difficulty in urinating
  • Poor urine stream (sudden or gradual)
  • Increased urinary frequency or urgency of urination
  • Dysuria (painful urination)
  • Bloody or dark urine
  • Incontinence
  • Lower abdominal pain
  • Discharge from urethra
  • Swelling of penis, testes, scrotum
  • Urinary retention
  • Recurrent infections of urinary tract

URETHRAL STRICTURE

The treatment of urethric stricture entails the placement of a suprapubic catheter allowing the bladder to drain urine through the abdomen. The treatment becomes compulsory in order to reduce acute problems like urinary retention and infection.

Surgical options depend on the location and length of the stricture. A small stricture can be corrected by visual internal urethrotomy. Post procedure, a urethral catheter is left in place.

For long strictures, open urethroplasty may be performed to remove the affected portion or replacing it with another tissue.

The latest technology Buccal Mucosal Graft Urethroplasty was published by Barbagli in 1996 in the journal of Urology. This technique of urethroplasty has revolutionized the management of urethral strictures all around the world. Subsequently, this technique was introduced in India in 1997. Barbagli had initially used free prepucial skin graft as a dorsal onlay. However, he started using buccal mucosa graft later on.

 

Indications

The indications for using Buccal Mucosa Graft Urethroplasty are as follows:

  1. A long bulbar stricture or
  2. A short bulbar stricture of non traumatic origin
  3. Post TURP stricture.

 

Investigation

The required investigation is the ascending urethrogram in order to reveal the site and length of the stricture.

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